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We are an equal opportunity employer. All applicants are considering without regard to race, color, disability, sex, national origin, age (for those age 40 or over), or any other basis protected by federal, state, or local law. This employment application is only active for 30 days. After this time period a separate employment application must be submitted in order to be considered for employment. Please know this information is solely intended for the use of A-ALL financial and will not be shared with third parties.
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| PERSONAL |
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| Date | |
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| First Name |
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Middle Name |
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Last Name |
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| Street Address |
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Social Security No. |
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| City | |
State | |
Zipcode | |
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| Phone No. |
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Email |
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| How did you find out about this job?
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| If hired, do you have reliable means of transportation to get to work?
Yes No If Yes, What is it?
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| Minimum salary expected | |
Are you at least 18 years old? Yes No |
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| If the job you are applying for requires driving: Yes No |
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| Driving License No. |
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State Issued: |
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Expiration Date: |
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| Are you legally eligible for employment in the U.S.? Yes
No (Proof of U.S. citizenship or immigration status will be required if hired.)
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EMPLOYMENT DATA |
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| Are you seeking:
What position(s) are you applying for?
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| What hours and shift(s) would you prefer to work? | |
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| Are you willing to work a flex schedule? Yes No |
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| Please indicate what shift(s) would you not be available to work: | |
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| Are you willing to work overtime? Yes No |
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| Are you willing to work overnight? Yes No |
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| Are you willing to work weekends? Yes No |
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| Are you currently employed? Yes No |
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| If hired, when would you be able to start? |
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| Have you ever worked for this organization before? Yes No |
If yes, name used
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| List any friends or relatives employed by this company |
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| Are you on layoff and subject to recall? Yes No |
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| Have you ever been discharged or asked to resign from any position? Yes No |
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| If yes, please describe: |
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| How many days have you missed from school or work within the last year other than approved vacation, sick, or disability leave? |
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| How many days have you been late to school or work within the last year other than approved vacation, sick, or disability leave? |
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| Please describe the type of business and what tasks might be required of you for the position in which you have applied. Are you able to perform these tasks with or without reasonable accommodation? Yes No |
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Comments
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Please describe which tasks, if any, you will need an accommodation to perform, and explain what type of accommodation you will need to perform: |
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Comments
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Please describe your current computer knowledge and abilities: Mark all programs you are familiar with Microsoft. |
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| Word Excel Outlook Powerpoint |
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Comments
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| EDUCATION (Select highest level attained.) |
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| Elementary
1
2
3
4
5
6
7
8
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| Secondary
9
10
11
12
GED
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| College
1
2
3
4
5
6
7
8
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| Name of School |
Name of School |
Name of School |
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| Location of School |
Location of School |
Location of School |
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| Degree and Major
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Minor |
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| If currently in high school, are you enrolled in a recognized co-op program? Yes No |
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| If yes, identify program and School: |
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| MILITARY SERVICE |
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| Are you a veteran? Yes No
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| If yes, give dates of service: From To
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| List any special skills or training:
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WORK HISTORY (Please list your last four employers. Begin with the most recent.) |
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| Company | | Phone No. with area code |
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| Street Address |
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| City | |
State | |
Zipcode | |
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| Dates of Employment: From | To: |
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| Salary: Beginning: |
Ending: |
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Job Title:
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Supervisor's Name and Title:
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| Describe duties briefly: |
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| Specific reason for leaving:
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| Company | | Phone No. with area code |
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| Street Address |
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| City | |
State | |
Zipcode | |
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| Dates of Employment: From | To: |
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| Salary: Beginning: |
Ending: |
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Job Title:
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Supervisor's Name and Title:
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| Describe duties briefly: |
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| Specific reason for leaving:
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| Company | | Phone No. with area code |
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| Street Address |
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| City | |
State | |
Zipcode | |
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| Dates of Employment: From | To: |
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| Salary: Beginning: |
Ending: |
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Job Title:
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Supervisor's Name and Title:
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| Describe duties briefly: |
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| Specific reason for leaving:
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| Company | | Phone No. with area code |
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| Street Address |
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| City | |
State | |
Zipcode | |
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| Dates of Employment: From | To: |
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| Salary: Beginning: |
Ending: |
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Job Title:
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Supervisor's Name and Title:
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| Describe duties briefly: |
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| Specific reason for leaving:
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| May we contact all of the employers listed above? Yes No
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| If not, tell us which one(s) you do not wish us to contact and why: |
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| How many jobs have you had in the last five years not listed above?
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| Why are you seeking a new position at this time?
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| Why do you think you might like working for this organization?
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| List any business-related outside interests and organizations you're active in: |
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